In the former Soviet Union, psychiatrists invented definitions of mental illness so warped that they came to include people guilty of nothing more than pursuing truth and justice. Dissidents routinely were tossed into psychiatric hospitals and tormented with psychotropic drugs merely because they had publicly disagreed with the government. If you opposed communism, the reasoning went, you had to be insane. Those and other outrageous practices were routine for decades. But with the Soviet collapse, there was a sense among psychiatrists and watchdog groups in Russia and elsewhere that Russian authorities had halted such flagrant abuse of medicine and psychiatry.
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Unfortunately, that may be false. As Chicago Tribune foreign correspondent Alex Rodriguez reported recently, Russian authorities are backsliding into Soviet-style repression, using psychiatry to suppress political opponents. "We're returning to this Soviet scenario when psychiatric institutions are used as punitive instruments," said Yuri Savenko, president of the Independent Psychiatric Association of Russia. "I call this not even punitive psychiatry but police psychiatry, when the main aim is to protect the state rather than to treat sick people."
One chilling account: Earlier this summer, Larisa Arap, an activist with former chess champion Garry Kasparov's movement opposed to Russian President Vladimir Putin, co-wrote an article alleging abusive practices at local psychiatric clinics. When she visited a Murmansk clinic to pick up a routine medical certificate to renew a driver's license, a doctor called police and had her delivered to a local asylum. The apparent diagnosis: Opposing Putin. "One of the doctors asked whether I thought it was normal to write such things," Arap's daughter Taisiya said. "She said, 'It's not possible to write such things. It's forbidden."' In other words, she must be crazy to write those things.
So now Arap languishes in a psychiatric facility, drugged and woozy.
That's a troubling throwback to Soviet days. The Soviets started to come clean and allegedly reform the system almost two decades ago. Officials acknowledged that psychiatry had been systematically used in the 1970s to suppress dissidents by declaring them mentally ill and committing them to asylums. It didn't take much to warrant such treatment.
The government outlawed tossing sane people into mental institutions in 1988. Control of special psychiatric hospitals was handed from the police to health authorities. In 1991, a panel of Soviet scientists and psychiatrists formally apologized for one infamous case of unjustly diagnosing and hospitalizing a dissident who spoke out against Communist Party corruption and a "personality cult" around then-leader Nikita Khrushchev.
The abuses today don't appear to be as widespread and systematic. But after so many years, why do they persist? One reason is that rule of law in Russia is still fragile. There are few checks and balances to prevent these kinds of things from happening. If a local psychiatrist or judge manages to commit someone for trumped-up reasons, there's no strong national authority willing to intervene. Courts officials are often corrupt and tend to do the bidding of local and regional authorities.
It's encouraging that some independent groups, such as Savenko's, are willing to stand up to authorities and expose abuse. What's needed now is the kind of unrelenting international scrutiny and pressure that forced reforms in the 1980s. That could come soon. Officials at the American Psychiatric Association say they're "very concerned" and are examining allegations of abuse, according Dr. Carolyn Robinowitz, president of the American Psychiatric Association. "If this correct, this is absolutely shameful and intolerable," she says.
If Soviet-style practices return, so must international scorn. Putin has striven over the past few years to "rebrand" Russia as a place that respects a certain amount of freedom of speech. It's not your father's Soviet Union, in other words. Except that, more and more, it is.
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